Critical Congenital Heart Disease Screening Program:

Performing Pulse Oximetry

(Pulse Ox) with the Infant Patient:
EDUCATION FOR PROVIDERS
Pulse Ox – DOs 2. Blood flow is needed to obtain
an accurate pulse ox reading.
1.  If you are using disposable pulse ox sensors, use a new, clean
Never attempt to obtain a pulse
sensor for each infant. If you are using reusable pulse ox sensors,
ox reading on the same extremity
clean the sensor with recommended disinfectant solution
that you have an automatic blood
between each infant. Dirty sensors can decrease the accuracy
pressure cuff.
of your reading and can transmit infection. A disposable wrap
should be used to secure the sensor to the site if you are using 3. Bright or infrared light, including

reusable sensors. bilirubin lamps and surgical lights,

can affect the accuracy of the
2. The best sites for performing pulse ox on infants are the great
reading. Ensure that the infant is
toe, thumb, and the outer aspect of the palm and the foot. An
not placed in bright or infrared
infant pulse ox sensor (not an adult pulse ox clip) should always
light while pulse ox is being
be used for infants.
performed. You may cover the
3. When placing the sensor on the infant’s skin, there should not pulse ox sensor with a blanket to
be gaps between the sensor and the infant’s skin. The sides of ensure that extraneous light does
the sensor should be directly opposite of each other. not affect the accuracy of your
4. Nail polish dyes and substances with dark pigmentation (such reading.
as dried blood) can affect the pulse ox reading. Assure that the 4. Do not use tape or your hand to
skin is clean and dry before placing the sensor on the infant. apply the pulse ox sensor to the
Skin color and jaundice do not affect the pulse ox reading. infant’s skin.
5. Movement, shivering, and crying may affect the accuracy of
the pulse ox reading. Ensure that the infant is calm and warm Pulse Ox - CAUTION!
during the reading. Swaddle the infant and encourage family
1. The pulse is needed to determine
involvement to promote comfort while obtaining the reading. If
the oximetry reading. Pulse ox
possible, conduct screening while the infant is awake.
is not accurate if the patient is
6. Pulse oximeters have different confidence indicators to ensure coding or is having a cardiac
that the pulse ox reading is accurate. Determine the confidence arrhythmia. Remember: No pulse,
indicators for the pulse oximetry equipment that you are using. no oximetry!
7. If an infant requires pulse ox monitoring for an extended 2. Pulse ox readings are not
amount of time, assess the site where the sensor is placed at instantaneous. The oximetry
least every two hours. Monitor for signs of irritation. reading that is displayed on the
monitor is an average of readings
Pulse Ox – DON’Ts over the past few seconds.
1.  Never use an adult pulse ox clip when obtaining a pulse ox
reading for an infant. Using an adult clip on an infant will give
you an inaccurate reading.

childrenscolorado.org/CCHDScreening p: 720-777-6820